Stomatitis

Dr. Muhammad Waqas (Ph.D.)

Assistant Professor (Clinical Veterinary Medicine)
Department of Veterinary Clinical Sciences,
Faculty of Veterinary & Animal Sciences,
University of Poonch Rawalakot
 Definition
• Stomatitis is the inflammation of oral mucosa
clinically characterized by;
– Partial or complete Anorexia
‫ن‬ ‫نٹ‬
– Smacking of lips (‫)ہ و وں کو مار ا‬
– Profuse salivation
• It includes;
– Glossitis (inflammation of the tongue)
– Palatitis or lampas (inflammation of the palate)
– Gingivitis (inflammation of the mucosa of gums)
• It is commonly an accompaniment of a systemic disease
• The oral lesions may vary from simple wound to
appearance of papules, vesicles, erosions, ulcers, heavy
deposits, or abnormal growths
 Etiology
• Stomatitis may be caused by;
–Physical agents
–Chemical agents
–Infectious agents
 Physical agents
• Trauma at oral examination
• Oral medicinal dosing with balling gun or sharp edged instruments
• Laceration of the tongue (irregular cut on the tongue).
• Accidental intake of hard metallic objects with feed i.e. nails or needles
‫ن‬
• Malocclusion of teeth (‫)دانت ٹھیک سے سیدھ میں نہ ہ و ا‬
• Eating frozen feed
• Drinking hot water
• Feeding on spiny plants or having sharp awns (‫)ريشہ دار‬. Very young
animals, e.g. 1-6-week-old lambs, are particularly susceptible to oral
trauma from abrasive feed (‫( کھرچنے واال‬
 Chemical agents
• Irritant drugs (Oral administration of chloral hydrate in over strong
concentration)
• Licking of counterirritants applied to skin including mercury and
cantharides compounds.
• Accidental intake of irritant substances (Acids, Alkalis, Phenolic
compounds)
• Manifestation of systemic poisoning, e.g. chronic mercury poisoning,
poisoning with bracken, furazolidone and some fungi (Fusarium spp. and
mushrooms) causes necrotic ulcers or erosions
 Infectious agents
• Cattle and Buffaloes:
– Necrobacillosis, Actinobacillosis, Actinomycosis, FMD, Vesicular
Stomatitis, BVD, Bovine Malignant Catarrh, Rinderpest, Infectious
Bovine Rhinotracheitis, Papillomatosis
• Sheep and Goats:
– Bluetongue, PPR, FMD, Contagious Ecthyma (ORF), Sheep and Goat
Pox, Mycotic dermatitis
• Horses
– Cheilitis and gingivitis (inflammatory nodules of the lips and gums
caused by plant awns), vesicular stomatitis, herpesvirus infections
 Pathogenesis
• The lesions of stomatitis are produced by the causative agents in three
ways;
– By applied directly to the mucosa
– By gaining entrance to mucosa by way of minor abrasions (Primary
Stomatitis)
– By localization in the mucosa from a viremia (Secondary Stomatitis -
occurrence of similar lesions in other organs or parts of the body,
and the presence of a systemic disease)
• The clinical signs of stomatitis are caused by the inflammation or
erosion of the mucosa and the signs vary in severity with the degree of
inflammation
 Clinical Signs
• Partial or complete anorexia
• Slow and painful mastication
• Smacking of lips
• Salivation (either frothy or profuse and drooling) may contain pus
(bacterial infection) or blood and shreds of mucosa (oral wound)
• An increased desire for water
• Enlargement of local lymph nodes and fetid odour is present on the
breath only if bacterial invasion of the lesion has occurred.
• Toxemia may be present in secondary stomatitis (Oral necrobacillosis
and other systemic viremias)
• Several different lesions of the oral cavity may be present and their characteristic appearances are as
follows.
– Papule: A small inflamed elevation of skin that is nonsuppurative
– Erosions are shallow, usually discrete, areas of necrosis, which are not readily seen in the early stages.
They tend to occur most commonly on the lingual mucosa and at the commissures of the mouth. The
necrotic tissue may remain in situ but is usually shed, leaving a very shallow discontinuity of the mucosa
with a dark red base.
– Vesicles are painful swellings of 1-2 cm diameter filled with clear serous fluid
– Ulcerative lesions penetrate more deeply to the lamina propria and are painful.
– Catarrhal stomatitis is manifested by a diffuse inflammation of the buccal mucosa and is commonly the
result of direct injury by chemical or physical agents.
– Mycotic stomatitis is characterized by a heavy, white, velvety deposit with little obvious inflammation or
damage to the mucosa.
– Gangrenous lesions are characterized by rapid and massive destruction of the tissue with foul odour
from breath.
A picture of a cat affected by severe
stomatitis, or inflammation throughout the
oral cavity
Feline stomatitis
 Cow with papular stomatitis, manifested
by reddish, raised, ulcerated lesions on
Vesicular Stomatitis the lower lip.
Courtesy of Dr. Sameeh M. Abutarbush
Vesicular Stomatitis (Gingivitis) Stomatitis (Glossitis)
 Clinical Pathology Necropsy Findings
Swabs collected from The oral lesions are easily
lesions should be examined observed but complete
for the presence of necropsy examinations should
pathogenic bacteria, fungi be carried out on all dead
animals to determine whether
or viruses
the oral lesions are primary
or/are local manifestations of
a systemic disease
 Diagnosis
• History of feeding
• Clinical signs
• Clinical Pathology
 Treatment
• Affected animals should be isolated, fed and watered in separate utensils if an infectious agent is
suspected.
• Atropine sulphate @ 0.1-1 mg/kg IM for hyper-salivation.
• High doses of Vitamin-C and B-complex for faster recovery.
• Fluids or semi-solid palatable feed should be offered during and after recovery. It may be fed by
stomach tube if oral feeding is not possible.
• Cleaning of the wound with Tinct. Iodine or 2% solution of Hydrogen peroxide.
• Frequent application of a mild antiseptic solution like 1 % suspension of a sulfonamide in glycerin,
or weak solution of KMnO4 (1:10000).
• Indolent ulcers require more vigorous treatment and respond well to curettage or cauterization
with a 4% silver nitrate solution.
• Use of systemic antibiotics or sulphonamides for primary or secondary infections, antifungal agents
in case of fungal stomatitis.
• Dextrose, Normal saline or Ringer solutions to combat dehydration and electrolytes imbalance